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Home My WebLink About198113 06/06/2011 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1 ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC CARMEL, INDIANA 46032 PO BOX 1106 CHECK AMOUNT: $3,941.85 s NOBLESVILLE IN 46061 CHECK NUMBER: 198113 CHECK DATE: 6/6/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4231500 106435 1,757.25 OIL 1207 4231400 GTO19426 2,184.60 GASOLINE i SALE 2252 DATE 05/25/11 17:37 :29 COUNT: START 0.0 END 302.3 GROSS DELIVERY 302.3 GALLONS 4817 UNLEADED GAS GOUC40LIKE 1 MULTIPLE DELIVERIES AT SITE 4 SALE 4590 DATE 05125/11 17:33:18 COUNT: START 0.0 END 317.7 GROSS 317.7 GALLONS 4040 DIESELEX ULS UN DISTILLATI i MULTIPLE DELIVERIES AT SITEt HAMILTON COUNTY CO-OP PO BOX 1166 NOBLESVILLE, IN 46061 CHARGE INVOICE Driver: GT GARY TEETERS Customer: 0090028761 Invoice ST 019426 BROOKSHIRE GOLF CLUB Date: 5/25/2011 CITY OF CARMEL Time: 17:35 12120 BROOKSHIRE PKWY CARMEL, IN 46033 Tres Terns Description Item Description Legend Quantity Unit Price Itee Total 01 NORMAL 104817 UNLEADED GAS GOV'T E 302.2000 3.41000 1030.50 WARNING CONVENTIONAL GASOLINE THIS PRODUCT DOES NOT MEET THE REQUIREMENTS FOR REFORMULATED GASOLINE AND RAY NOT BE USED IN ANY REFORMULATED GASOLINE COVERED AREA. THIS PRODUC T CONTAINS PRESCRIBED LEVELS OF INTAKE VALVE DETERGENT ADDITIVE. MNFORMS TO;REQUIREMENTS FOR A 9.0 P.S.I RAX. RVP GASOLINE DURING THE MONTHS OF MAY 1ST THROUGH SEPTEMBER 15TH. State Road Tax 0.18000 54.40 01 NORMAL 154040 DIESELEX ULS UN 19 E 317.7000 3.52M 1118.30 01 NORMAL 194070 PETRO VOLUME DISCOUN 619.9000 0.03000 -18.60 Legend: Invoice Subtotal: 2,184.60 E= Metered, T= Taxable, *centered by Hand Indiana Sales Tax On: 0.60 0.00 Invoice Total: 2,184.60 WARNING PETROLEUM PRODUCTS NOT TO BE USED FOR STARTING OR KINDLING FIRES. GASOLINES NOT SOLD FOR ILLUMINATING OR CLEANING PURPOSES. IN CASE OF EMERGENCY CONTACT CHEMTREC AT 1 -809- 424 -9309 WE APPRECIATE YOUR BUSINESS!!! Prescribed by State Board of Accounts City Form No. 201 (Rev. 199: ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 05/25/11 GT 019426 Fuel 82,184.6 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Hamilton County CO -OP IN SUM OF P.O. Box 1106 Noblesville, IN 46061 $2,184.60 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1207 GT 019426 42- 314.00 $2,184.60 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Wednesday, June 01, 2011 Director, Brooks f e Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund Noblesville -Office Horton Feed Grain Gray Storage 773 -0870 758 -4463 776 -4155 H amilton County Grain Terminal Noblesville Petroleum Merchandising COOPERATIVE ASSOCIATION, INC. 773 -2599 Plant Food Station 773 -2685 776 -4143 16222 Allisonville Road P. O. Box 1106 Noblesville, Indiana 46061 o CARMEL STREET DEPT <CHARGE SALE) L 3400 W 131ST STREET o CARMEL IN 46074 ACCOUNT N0. I PURCHASE ORDER NO. SALES TAX LICENSE NUMBER SALESMAN TERMS: INVOICE NO. DATE PAGE PAYMENT DUE ON THE LAST DAY OF THE 31175 C O MONTH FOLLOWING MONTH OF PURCHASE. 1 0 6 4 3 5 0 5/ 2 6/ 11 1 RETURN ITEMS MUST BE ACCOMPANIED BY THIS INVOICE. 'OD LUSE OIL 194050 165.0000 GAL 10.6500 1757.25 TICKET 134 SIGNED BY #224 All accounts subject to court RECEIVED IN GOOD ORDER AMOUNT PAID CASH DISCOUNT costs and attorney fees 0 legal action is necessary to collect CUSTOMER said amount. SIGNATURE 00 1757.25 Emergency Contact: LATE CHARGE PER MONTH PER ANNUM Chemtrec 1- 800 424 -9300 CUSTOMER COPY Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 05/26/11 106435 $1,757.25 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk- Treasurer VOUCH N O. WARRANT NO. ALLOWED 20 Hamilton Co. Co -op IN SUM OF P. O. Box 1106 Noblesville, IN 46061 $1,757.25 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 2201 106435 42- 315.00 $1,757.25 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Wednesday, June 01, 2011 Street Commis I er a., n er" s er Title Cost distribution ledger classification if claim paid motor vehicle highway fund